Pitt Alumna Helping New Mothers Thrive Using Evaluation Tool Bearing Her Name

In a medically underserved 10-county rural region of south-central Georgia, Jennifer Barkin is principal investigator overseeing $8 million in federal and foundation grants to provide services targeted to improve maternal and infant health and wellbeing.

To gain insight into the areas that postpartum mothers are handling well, where they are experiencing challenges, and to assess the effectiveness of the interventions, she employs a tool she developed and copyrighted during her doctoral studies at Pitt.

The Barkin Index of Maternal Functioning (BIMF) is a 20-item self-report measure that captures how mothers are performing in terms of infant-child interaction, adjustment, infant care, self-care, and psychological well-being.

Barkin, who is Professor and Vice Chair of Community Medicine and Obstetrics and Gynecology at the Mercer School of Medicine, created the index while working as an analyst at Pitt’s Epidemiology Data Center (EDC).

Her dissertation advisor, Stephen Wisniewski, co-director of the EDC, introduced her to Katherine Wisner, a renowned reproductive psychiatrist who completed a postdoctoral fellowship at the Pitt Graduate School of Public Health. Together, they laid the groundwork for the index.

“The project was appealing to me because it combined mental and reproductive health and engaged some of my methods background in biostatistics and epidemiology,” Barkin said. “I have always had empathy for mothers and the BIMF has connected me to populations of mothers in need all over the world. It is a labor of love.”

Barkin said she did not immediately consider the intellectual property ramifications when developing the index. Fortunately, her mentors urged her to contact the Innovation Institute (part of the Office of Innovation and Entrepreneurship) to explore copyright protection.

“It’s one of those events you reflect on as divine intervention,” she said.

“I have collaborated with the Innovation Institute since 2009, when I filed for a copyright, and they have provided tremendous support as the BIMF gained traction in maternal child health circles,” Barkin said. “When organizations or individuals express interest in licensing the BIMF, I meet with (licensing associate) Carolyn Weber to work out potential issues. Carolyn and I have worked with everything from small to mid-sized clinical practices to large pharmaceutical companies.”

The BIMF has been licensed 13 times. The first new drug approved by the Food and Drug Administration specifically designed for post-partum depression licensed the index as part of its clinical trials. It is also used by clinicians, researchers and community-based organizations.

“With each BIMF query, I am reminded how fortunate I was to train at the University of Pittsburgh,” Barkin said. “Simply stated, the BIMF would not have been this successful without the strong support and expertise of the Innovation Institute.”

The BIMF has been translated into 22 languages, and Barkin has worked with several international organizations to both implement and interpret the measure. It also has been modified and is available for mothers with children in the Neonatal Intensive Care Unit, parents with older children, and caregivers with school-aged children.

“Recently, a group of occupational therapists told me that they use the measure to support skill building in their patient population – they said they thought the BIMF was built with occupational therapy in mind,” Barkin said. “Though it was not built specifically for that purpose, it is affirming that the measure is being used to help mothers function better – which was its intended use.”

The BIMF has been well-received in scientific circles. In a systematic review of maternal health assessments, the BIMF received an “A” grade across several parameters.

For Barkin’s current grants in central Georgia, the BIMF is part of the assessment battery that perinatal women complete at select time points during their matriculation through South Georgia Healthy Start program, which supports service delivery to pregnant and postpartum women, their partners, and infants (up to 18 months).

“The goal is to track maternal functional trajectories over time, and as more nuanced services are added to the program,” she said. “Theoretically, the additional services we are adding should further improve the program’s already impressive outcomes .”

The BIMF is just one example of measurement scales and indexes developed by Pitt innovators over the years. In fact, the most licensed piece of intellectual property in the university's history is the Pittsburgh Sleep Quality Index (PSQI), developed by Daniel Buysse, Distinguished Professor of Psychiatry, Medicine, and Clinical and Translational Science and UPMC Endowed Chair in Sleep Medicine.

The PSQI has become the gold standard for measuring sleep quality for academic studies and clinical studies conducted by pharmaceutical companies. The index has been translated into more than 50 languages. Building off the success of the PSQI, Buysse has authored and copyrighted more than a half dozen other sleep and insomnia-related questionnaires, measurement scales, and interventions that are in wide distribution.

Pitt-copyrighted scales and questionnaires:

1. Barkin Index of Maternal Functioning by Jennifer Barkin, Katherine Wisner, Joyce Bromberger, Scott Beach, Martha Terry, and Stephen Wisniewski
2. Pittsburgh Sleep Quality Index, by Daniell Buysse, Charles Reynolds, Timothy Monk, Susan Berman, and David Kupfer
3. I-GERQ (Infant Gastrointestinal Reflux Questionnaire) by Susan Orenstein, formerly Department of Pediatrics, School of Medicine

 4. Acute Otitis Media Severity of Symptoms Scale (AOM-SOS SCALE) by Alejandro Hoberman, Executive Vice Chair, Department of Pediatrics and Nader Shaikh, Professor of Pediatrics

 5. Pittsburgh Fatigability Scale (PFS) by Nancy Glynn, Associate Professor, Department of Epidemiology

If you have questions regarding copyrights of materials you have developed as a Pitt faculty, student or staff, contact the Office of Innovation and Entrepreneurship.